The NH.S.

There’s been a lot of discussion over the last few months comparing the NHS in England and Wales, particularly with regard to cancer, so let’s look at the facts.

If you live in Wales, you have £10 per head more spent on your cancer care than in England. You also more likely to be seen within target treatment times. You will have faster access to approved drugs. You will see a state-of-the-art, brand new cancer treatment centre being built at Velindre over the next few years.

Much of the debate has concentrated on the cancer drugs fund in England, which we don’t have in Wales, but there are rational reasons for this. In England and Wales, there is a body called the National Institute for Care and Health Excellence (NICE), which looks at new drugs and decides whether they are value for money; does their cost justify their effectiveness for certain conditions? Some drugs are approved for use in the NHS but some are turned down.

In England, it’s possible for these non-approved drugs to be funded via the cancer drugs fund. However, England has just introduced a new value for money element there as well, which defeats the whole object of the fund. In Wales, we have another body, called the All Wales Medicines Strategy Group, which evaluates new medicines that haven’t been through the NICE process for use in the NHS. People can also apply for funding for drugs for any condition, not just cancer, which aren’t available on the NHS through the IPFR system.

The problem with the English system is that in the past, companies whose drugs were rejected as too expensive often came back with a lower price. That discipline is no longer there, so the price of cancer drugs is higher than it should be. It also discriminates against people with other serious conditions, such as MS or heart disease, who can’t get access to drugs in the same way.

Sadly, the drugs funded through England’s fund are not life-saving drugs. For some people, it’s true to say their lives might be extended – sometimes for weeks, sometimes more. Those drugs can also be funded in Wales under the IPFR process, according to a person’s circumstances.

These are always difficult decisions. In England they’ve focused on drugs; we focus on treatment and speed of access to treatment. We know from the events of the last few weeks that Whitehall is in no position to lecture us on the NHS after the various emergencies declared in English hospitals, which I take no satisfaction from. We’ve also seen the Prime Minister plead that the English NHS shouldn’t be a political football, while kicking the Welsh NHS all over the park.

The NHS deserves an honest approach. There is greater and greater demand and we as a society need to think about how we fund it and what our expectations should be. London politicians attacking the Welsh NHS undermines that approach.